Table 1 Main characteristics of modelling studies with GLA vs.NPH (listed in order of increasing ICER in €/QALYa)
Author/study (year) country/perspective/time horizon (discount rate) initiator | Type of economic evaluation/methodological approach | Effect of GLA on HbA1c compared to NPH | Effect of GLA on frequency of hypoglycaemia compared to NPH | Long-term complications of diabetes | Utilities | Results for GLA compared to NPH | ICERs in €/QALYa |
|---|---|---|---|---|---|---|---|
Brändle et al. [25] | |||||||
Switzerland third party payer perspective 40 years (C 3.5%, E 3.5%) Sanofi-Aventis | CUA DES based on McEwan et al. [23] and DCCT | -0.19% points according to Mc Ewan [23] | Symptomatic: -23% Severe: -24% Nocturnal: -24% All reductions based on [7] | Reduction depending on HbA1c reduction | Reduction by: 1. hypoglycaemia 2. fear of hypoglycaemia 3. long-term consequences | IU: 0.238 QALYs more IC: CHF 1,476 less ICER: GLA dominant | dominant |
McEwan et al. [23] Scenario 5 | |||||||
UK NHS 40 years (C 3.5%, E 3.5%) Sanofi-Aventis | CUA DES based on DCCT | -0.45% pointsb | - | Reduction depending on HbA1c reduction | Reduction by: 1. long-term consequences | IU: 0.12 to 0.34 QALYs more IC: £ 1,043 to £ 1,371 more ICER: £ 1,096/QALY | € 3,859 |
Warren et al. [24] | |||||||
UK NHS 9 years ( C 3.5%, E 3.5%) NICE | CUA ScHARR Model | Only in sensitivity analysis: -0.14% points [33] | Symptomatic: -42% [35] Severe: -52% [35] | In sensitivity analysis reduction depending on HbA1c reduction | Reduction by: 1. hypoglycaemia 2. fear of hypoglycaemia 3. long-term consequences only in sensitivity analysis | IU: n/a IC: £ 573 to £ 816 more ICER: £ 3,496 to £ 4,978 per QALY | € 4,073 to € 5,800 |
McEwan et al. [23] Scenario 1-3 | |||||||
UK NHS 40 years (C 3.5%, E 3.5%) Sanofi-Aventis | CUA DES based on DCCT | - | Severe: -25 to -28%b Nocturnal: -17 to -22%b | - | Reduction by: 1. hypoglycaemia 2. fear of hypoglycaemia | IU: 0.12 to 0.34 QALYs IC: £ 1,043 to £ 1,371 more ICER: £ 8,807 to £ 7,391 per QALY | € 8,943 to € 10,656 |
McEwan et al. [23] Scenario 4 | |||||||
UK NHS 40 years (C 3.5%, E 3.5%) Sanofi-Aventis | CUA DES based on DCCT | -0.19% pointsb | - | Reduction depending on HbA1c reduction | Reduction by: 1. long-term consequences | IU: 0.12 to 0.34 QALYs more IC: about £ 1,043 to £ 1,371 more ICER: £ 1,096/QALY | € 11,818 |
Grima et al. [22] | |||||||
Canada Canadian health ministry 36 years (C 5%, E 5%) Sanofi-Aventis | CUA State Transition Model based on UKPDS and DCCT | -0.4% points [34] | - | Reduction depending on HbA1c reduction | Reduction by: 1. long-term consequences | IU: 0.08 QALYs more IC: CAN$ 1,398 more ICER: CAN$ 20,799/QALY | € 13,364 |
Warren et al. [20] | |||||||
UK NHS 9 years (C 3.5%, E 3.5%) NICE | CUA ScHARR Model | Only in sensitivity analysis: -0.14% points [33] | Symptomatic: -19% [20] Severe: -52% [35] | Reduction depending on HbA1c reduction | Reduction by: 1. hypoglycaemia 2. fear of hypoglycaemia 3. long-term consequences only in sensitivity analysis | IU: n/a IC: £ 962 more ICER: £ 32,244/QALY | € 37,567 |
Cameron et al. [21] | |||||||
Canada Canadian health ministry 60 years (C 5%, E 5%) CADTH | CUA based on CORE-Model | -0.11% points [5] | Moderate: -18% [5] Severe: -18% [5] | Reduction depending on HbA1c reduction | Reduction by: 1. hypoglycaemia 2. fear of hypoglycaemia only in sensitivity analysis 3. long-term consequences | IU: 0.039 QALYs more IC: CAN$ 3,423 more ICER: CAN$ 87,932/QALY | € 57,002 |